Original Investigation

Protocol for Nursing Care in Endoscopic Retrograde Cholangiopancreatography in the Endoscopy Unit

10.5152/imj.2013.29

  • Gamze Kurt
  • Didem Gürsoy
  • Seval Yavaş
  • Oğuz Koç
  • Y. Selim Sarı
  • Vahit Tunalı
  • Mehmet Aslan

Received Date: 13.07.2011 Accepted Date: 24.08.2012 IMJ 2013;14(2):106-108

Objective:

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an invasive method used in the diagnosis and therapy of pancreaticobiliary diseases. Pre- and post-procedural preparation, follow up and management of ERCP patients by the associated nursing team play a critical role. Serious complications may occur, especially after invasive therapeutic procedures in ERCP. In such patients, nursing care in patient management is a vital part of the procedure.

Methods:

Between 2009 and 2011, a predefined protocol was applied to the treatment of ERCP patients in our unit. This protocol included preprocedural 8-hour fasting, a prophylactic single-dose first-line cephalosporin injection, postprocedural close nursing care and a serum biochemical panel performed at 3-24 hours. Pre-procedural and post-procedural diagnosis, procedure details, complications and discharge time were all recorded in our database.

Results:

During the study period, we performed 140 ERCP procedures. Mechanic biliary obstruction and extraction was the most common indication and therapeutic procedure, respectively. Hyperamylasemia was found in 45 patients after the procedure. Perforation, which is treated surgically, microperforation and pancreatic pseudocyst were found to have developed in one patient each. 85% of patients were discharged the morning after the procedure.

Conclusion:

In the treatment of hepatopancreatobiliary diseases, ERCP is a commonly used invasive procedure that carries a high risk of mortality. Postprocedural close care and management is essential to decrease the risk of mortality. Sufficient technical grounding in the use of equipment, as well as the education and experience of ERCP nurses, are also important factors in avoiding the complications that can occur after this challenging ERCP procedure.

Keywords: ERCP, multidisciplinary study, nursing care